JASON L KONZELMANN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120913

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

KONZELMANN

Suffix

Business Name

JASON L KONZELMANN MD

Original Issue Date

05/16/2008

Effective Date

06/12/2014

Expiration Date

07/31/2017

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/01/2017